A5025558070- Dementia and Cognitive Impairment Research
- Pharmaceutical Practices and Patient Outcomes
- Pregnancy and preeclampsia studies
- Chronic Disease Management Strategies
- Opioid Use Disorder Treatment
- Pregnancy and Medication Impact
- Atrial Fibrillation Management and Outcomes
- Maternal Mental Health During Pregnancy and Postpartum
- Gestational Diabetes Research and Management
- Health Systems, Economic Evaluations, Quality of Life
- Maternal and Perinatal Health Interventions
- Prenatal Substance Exposure Effects
- Emergency and Acute Care Studies
- Birth, Development, and Health
- Global Maternal and Child Health
- Pain Management and Opioid Use
- Musculoskeletal pain and rehabilitation
- Cardiac Arrhythmias and Treatments
- Healthcare Policy and Management
- Pneumonia and Respiratory Infections
- Blood Pressure and Hypertension Studies
- Intensive Care Unit Cognitive Disorders
- Machine Learning in Healthcare
- Medication Adherence and Compliance
- Pharmacological Effects and Toxicity Studies
Kaiser Permanente Washington Health Research Institute
2016-2025
University of Washington
2016-2025
Kaiser Permanente
2010-2024
Group Health Cooperative
2008-2018
Brigham Young University
2018
NYU Langone Health
2018
Yale University
2018
Rutgers New Jersey Medical School
2018
Rutgers, The State University of New Jersey
2018
Duke University
2018
Many medications have anticholinergic effects.In general, anticholinergicinduced cognitive impairment is considered reversible on discontinuation of therapy.However, a few studies suggest that anticholinergics may be associated with an increased risk for dementia.OBJECTIVE To examine whether cumulative use higher incident dementia. DESIGN, SETTING, AND PARTICIPANTSProspective population-based cohort study using data from the Adult Changes in Thought Group Health, integrated health care...
More than 1.5 million US adults use stimulants and other medications labeled for treatment of attention-deficit/hyperactivity disorder (ADHD). These agents can increase heart rate blood pressure, raising concerns about their cardiovascular safety.To examine whether current prescribed primarily to treat ADHD is associated with increased risk serious events in young middle-aged adults.Retrospective, population-based cohort study using electronic health care records from 4 sites (OptumInsight...
In Brief OBJECTIVE: To test the association of elective induction labor at term compared with expectant management and maternal neonatal outcomes. METHODS: This was a retrospective cohort study all deliveries without prior cesarean delivery in California 2006 using linked hospital discharge vital statistics data. We each gestational age (37–40 weeks) as defined by The Joint Commission vertex, nonanomalous, singleton deliveries. used multivariable logistic regression to delivery, operative...
<b>Objective</b> To determine whether higher cumulative use of benzodiazepines is associated with a risk dementia or more rapid cognitive decline. <b>Design</b> Prospective population based cohort. <b>Setting</b> Integrated healthcare delivery system, Seattle, Washington. <b>Participants</b> 3434 participants aged ≥65 without at study entry. There were two rounds recruitment (1994-96 and 2000-03) followed by continuous enrollment beginning in 2004. <b>Main outcomes...
<h3>Objective:</h3> We sought to determine whether in the absence of clinical stroke, people with atrial fibrillation experience faster cognitive decline than without fibrillation. <h3>Methods:</h3> conducted a longitudinal analysis Cardiovascular Health Study, community-based study 5,888 men and women aged 65 years older, enrolled 1989/1990 or 1992/1993. Participants did not have history stroke at baseline. were censored when they experienced incident stroke. Incident was identified by...
Importance Modifiable risk factors are hypothesized to account for 30% 40% of dementia; yet, few trials have demonstrated that risk-reduction interventions, especially multidomain, efficacious. Objective To determine if a personalized, multidomain reduction intervention improves cognition and dementia profile among older adults. Design, Setting, Participants The Systematic Multi-Domain Alzheimer Risk Reduction Trial was randomized clinical trial with 2-year intervention. A total 172 adults...
Background: Obesity is associated with increased risk of atrial fibrillation (AF), but it unknown whether the association differs by duration or persistence AF.It also to what extent cardiovascular factors may mediate this association.Methods: This population-based case-control study included 425 subjects new-onset AF and 707 controls.The cases were identified through International Classification Diseases, Ninth Revision codes for inpatient outpatient visits verified medical record...
Objectives To examine whether use of opioids or benzodiazepines is associated with risk community‐acquired pneumonia in older adults. Design Population‐based case–control study. Setting An integrated healthcare delivery system. Participants Community‐dwelling, immunocompetent adults aged 65 to 94 from 2000 2003. Presumptive cases were identified health plan automated data and validated through medical record review. Two controls selected for each case pneumonia, matched on age, sex, calendar...
Nonsteroidal anti-inflammatory drugs (NSAIDs) may prevent Alzheimer dementia (AD).We analyzed the association of prior NSAID exposure with incident and AD in Adult Changes Thought population-based cohort aged > or = 65 years (median 74.8) at enrollment. Participants were members Group Health, which provided computerized pharmacy dispensing records from 1977 onward. We studied 2,736 dementia-free enrollees extensive data, following them biennially for up to 12 identify AD. Cox proportional...
To determine whether atrial fibrillation (AF) is associated with risk of incident dementia or Alzheimer's disease (AD), beyond its effect on stroke.
Atrial fibrillation (AF) is a common arrhythmia that affects more than 2 million people in the United States. We sought to determine whether risk of incident AF among patients treated for hypertension differs by degree blood pressure control.A population-based, case-control study 433 with verified and 899 controls was conducted investigate relationship between average achieved systolic (SBP) diastolic (DBP) AF. All were members an integrated health-care delivery system pharmacologically...
ABSTRACT Purpose To evaluate the validity of health plan and birth certificate data for pregnancy research. Methods A retrospective study was conducted using administrative claims from 11 U.S. plans corresponding state departments. Diagnoses, drug dispensings, procedure codes were used to identify infant outcomes (cardiac defects, anencephaly, preterm birth, neonatal intensive care unit [NICU] admission) maternal diagnoses (asthma systemic lupus erythematosus [SLE]) recorded in live born...
Objectives To determine whether prescription opioid use is associated with higher dementia risk or greater cognitive decline. Design Prospective cohort study. Setting Group Health, an integrated healthcare delivery system. Participants Community‐dwelling individuals aged 65 and older without at least 10 years of Health enrollment baseline (N = 3,434; median age 74). Measurements The Cognitive Abilities Screening Instrument (CASI) was administered every 2 years. Low scores triggered detailed...
Heart failure (HF) is associated with cognitive impairment. However, we know little about the time course of change after HF diagnosis, importance comorbid atrial fibrillation, or role ejection fraction. We sought to determine associations incident rates decline and whether these differed by fibrillation status reduced versus preserved Participants were 4864 men women aged ≥65 years without a history free clinical stroke in CHS (Cardiovascular Health Study)-a community-based prospective...
Objectives To determine whether higher cumulative proton pump inhibitor ( PPI ) exposure is associated with greater dementia risk. Design Prospective population‐based cohort study. Setting Kaiser Permanente Washington, an integrated healthcare delivery system in Seattle, Washington. Participants Individuals aged 65 and older without at study entry (N = 3,484). Measurements were screened for every 2 years, those who positive underwent extensive evaluation. Dementia outcomes determined using...
Abstract Purpose Calcium channel blockers and beta‐blockers (BBs) are widely used during pregnancy, but data on their safety for the developing infant scarce. We population‐based from 5 HMOs to study risks perinatal complications congenital defects among infants exposed in‐utero. Methods studied women older than 15 years delivering an between 1/1/96 12/31/00, who had been continuously enrolled with prescription drug coverage ≥1 year prior delivery. Information dispensings, inpatient,...
ABSTRACT Purpose To validate an algorithm that uses delivery date and diagnosis codes to define gestational age at birth in electronic health plan databases. Methods Using data from 225 384 live born deliveries women aged 15–45 years 2001–2007 within eight of the 11 plans participating Medication Exposure Pregnancy Risk Evaluation Program, we compared (1) algorithm‐derived versus “gold‐standard” obtained infant certificate file (2) prenatal exposure status two antidepressants (fluoxetine...
Little is known about the extent of antiepileptic drug (AED) use in pregnancy, particularly for newer agents. Our objective was to assess whether AED has increased among pregnant women US, 2001-2007. We analysed data from Medication Exposure Pregnancy Risk Evaluation Program (MEPREP) database, 1 January 2001 31 December 2007. identified liveborn deliveries women, aged 15-45 years on delivery date, who were members MEPREP health plans (n=585615 deliveries). exposure AEDs, determined through...
Objectives To evaluate the associations between anesthesia and dementia or Alzheimer's disease ( AD ) risk using prospectively collected data. Design Cohort study. Participants Community‐dwelling members of Adult Changes in Thought cohort aged 65 older free at baseline (N = 3,988). Measurements self‐reported all prior surgical procedures with general neuraxial (spinal epidural) reported new every 2 years. People undergoing high‐risk surgery anesthesia, other exposures were compared those no...
Early recognition of dementia would allow patients and their families to receive care earlier in the disease process, potentially improving management patient outcomes, yet nearly half with are undiagnosed. Our aim was develop validate an electronic health record (EHR)-based tool help detect unrecognized (EHR Risk Alzheimer's Dementia Assessment Rule [eRADAR]).
Abstract Purpose Health plan claims may provide complete longitudinal data for timely, real‐world population‐level COVID‐19 assessment. However, these often lack laboratory results, the standard diagnosis. Methods We assessed validity of ICD‐10‐CM diagnosis codes identifying patients hospitalized with in U.S. databases, compared to linked among six Food and Drug Administration Sentinel System partners (two large national insurers, four integrated delivery systems) from February 20–October...